The Practice of Community Based Health Insurance in Ethiopia: the Case if Meket District in Amhara Region
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Date
2019-06
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Addis Ababa University
Abstract
The issue of Community Based Health Insurance is an emerging and promising concepts to access affordable and effective health care services in Low and Middle income countries. The aim of the introduction of Community Based Health Insurance is to mobilize additional resources to the health sector. Accordingly, the main objectives of this study was to assess the practice and challenges of CBHI in the rural area of Ethiopia; particularly in Meket District, North Wollo Zone of Amhara region. To conduct this study; mixed research approach was employed to gather data from 173 respondents (60.7% male and 39.3% female households) for household survey and informants of IDIs, KIIs and FGDs. The quantitative data were analyzed and presented using descriptive statistics such as table, percent and graphs in SPSS version 21. Primary data have been collected qualitatively through open-ended questions like, in-depth interview from purposively selected beneficiary households, KII from four CBHI employed staffs and woreda administration head and FGD from kebele council, CBHI beneficiaries, health extension workers, kebele managers and DAs. The result of the study shows that, the majority of household respondents (82.7%) cover their health expenses before enrolling CBHI were through OOP, limited beneficiaries sense of belongingness and ownership in managing, administering and decisions about the scheme. Kebele/village administration forced households to pay the premium. The findings also indicated that, there were gaps in design and implementation of the program, in adequate supply of medicines, lack of adequate supply of laboratory equipment, long process to refer to the contracted health facilities, poor delivery of service by health facilities, Lack of skilled man power in health facilities, professionals didn’t provide equal services and threatened indifferently to member of CBHI and non- member beneficiaries. A number of households didn’t have membership ID even they paid the premium, long process of refund of money to the beneficiaries, delay in renewal of membership ID and households not bring full family registration. Finally, the study provides an implication to different actors like; program and policy, social work Education and implementation to research. The governments should provide holistic awareness to the community on CBHI, improve and shorten the referral processes, should provide comprehensive and quality health services to the members, CBHI should provide adequate supply of medicine and medical equipment by working in collaboration with Ethiopian Pharmaceutical Fund Supply Agency (PFSA) and participating members in decision making process to provide trust and sense of ownership to the communities.
Key words: Household, subsidy, indigent, CBHI, Beneficiaries, Enrollment, Out Of Pocket
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Keywords
Household, subsidy, indigent, CBHI, Beneficiaries, Enrollment, Out Of Pocket